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Heart 99:376-381 doi:10.1136/heartjnl-2012-302616
  • Obesity and the heart
  • Original article

Altered cardiovascular autonomic regulation in overweight children engaged in regular physical activity

  1. Massimo Pagani1,3
  1. 1Centro di ricerca Terapia Neurovegetativa e Medicina dell'esercizio, Dipartimento Scienze Cliniche, Università degli Studi di Milano, Milano, Italy
  2. 2Dipartimento di RiabiIazione e Recupero Funzionale, IRCCS Istituto Clinico Humanitas, Rozzano, Italy
  3. 3U.O. Telemedicina e Medicina dello Sport, Ospedale “Luigi Sacco”, Milano, Italy
  1. Correspondence to Dr Daniela Lucini, Dipartimento di Riabilitazione e Recupero Funzionale, IRCCS Istituto Clinico Humanitas, Rozzano, Italy; daniela.lucini{at}unimi.it
  • Received 28 June 2012
  • Revised 11 September 2012
  • Accepted 18 September 2012
  • Published Online First 19 October 2012

Abstract

Overweight (OW) and obesity in children are important forerunners of cardiovascular risk, possibly through autonomic nervous system (ANS) dysregulation, while physical exercise exerts a beneficial influence. In this observational study we hypothesise that OW might influence ANS profile even in a population performing high volume of supervised exercise. We study 103 young soccer players, homogeneous in terms of gender (all male), cultural background, school, age (11.2±1 years) and exercise routine, since they all belong to the same soccer club, thus guaranteeing equality of supervised training and similar levels of competitiveness. ANS is evaluated by autoregressive spectral analysis of heart rate and systolic arterial pressure (SAP) variabilities. We estimate also the accumulated weekly Metabolic Equivalents and time spent in sedentary activities. We subdivide the entire population in two subgroups (normal weight and OW) based on the International Obesity Task Force criteria. In OW soccer players (10.7% of total group) we observe an altered profile of autonomic cardiovascular regulation, characterised by higher values of SAP (113±4 vs 100±1 mm  Hg, 39.7±3 vs 66.2±10%), higher Low Frequency variability power of SAP (an index of vasomotor sympathetic regulation) (12±3 vs 4.5 mm  Hg2) and smaller spontaneous baroreflex gain (an index of cardiac vagal regulation) (19±3 vs 33 ±3 ms/mm  Hg) (all (p<0.02)). Moreover Correlation analysis on the entire study population shows a significant link between anthropometric and autonomic indices. These data show that OW is associated to a clear autonomic impairment even in children subjected to an intense aerobic training.